hey guys it's Ryan in this video we're gonna continue to talk about oral pathology and now it's the moment you've all been waiting for so these next two are really big categories and we're finally talking about lesions that are directly related to the teeth so Adana genic cysts are derived from cells associated with tooth formation so idato referring to tooth and genic reference information and basically residual odontogenic epithelium can undergo the syste fication process at any time and except for a few the stimulus for cystic change is kind of unknown so cysts by definition our cavities lined by an epithelium and that's super important as we'll see when we talk about each of these odontogenic cysts so first we have the radicular systems also called a periapical assist as the most common odontogenic cysts that we're going to talk about in this video so it's probably the most important one to know a lot of information about so radiographically it's a radial lucency at the apex of the root so it's this giant shadow here and it's around the apex which is why it's also called a periapical cyst or around the apex and radicular referring to its association with the root now it's always associated with a non vital tooth and non vital tooth has a necrotic pulp which causes periapical inflammation so you can see this giant cavity here bacteria have a really quick way to get an access all this nutritious pulp and can travel down and secrete their bacterial byproducts and cause inflammation and basically wreak havoc at the base of the root at its apex and this is probably a bit of an oversimplification but an acute inflammation would result in more of a naps whereas a chronic inflammation would result more in a granuloma where the body has more time to mount a response and involves granulation tissue so this next bullet point is kind of wordy but it's actually super super important so we'll kind of break it down so we have these epithelial rests of malice a from the hurt wigs epithelial root sheath within a pocket of inflammation encapsulate the lesion resulting in the formation of a cyst so what the heck does that all mean well rests are basically residual or remainders from tooth development and these happen these the ERM happen to be residual cells from her twigs epithelial root sheath which is a important structure in tooth embryology so basically associated with the cervical loop of the enamel organ of a developing tooth and these rests or residual cells from development are the reason are the cause of this epithelial lining that forms this cavity and the actual etiology the reason why these epithelial cells form a lining is because of this infection and inflammation due to a necrotic pulp so necrotic pulp is the etiology and the ERM are the is the origin of the epithelial lining of that cyst so treatment would be root canal treatment or a Pico ectomy where you do a direct surgical access of the apex or extraction of the tooth with curettage which means you're scraping the walls of this lesion to take care of any infection or inflammation next we have done teacher assist which is probably the second most important or the second most common odontogenic cyst as also called an eruption cyst if the lesion occurs over interrupting tooth in a child and whereas in the radicular cyst we had this radial lucency centered around the apex ford integer assist now we have the radial lucency which is attached to the cej or the cementoenamel junction where the enamel meets the cementum of the root and you can see how this radial lucency comes neatly attached to that point of the tooth now it's most common with canines and third molars and here this looks like it could be a second molar or third molar let's just say this is in fact a wisdom tooth and it's an accumulation of fluid between the crown and the reduced enamel epithelium which if you notice I hadn't read the epithelia rests of malice a which is a an embryo logic term and embryo logic structure and here again we have reduced a mammal epithelium which is another structure from tooth development and treatment for this would be excision but it may be the source of a feature of dona genetic tumor next we have lateral periodontal cyst which is most common in the mandibular premolar area as seen here now this one is always associated with the vital twos so you can sort of contrast it to the radicular cyst in two main ways where the radicular cyst was associated always with non-vital teeth and it was centered over the apex whereas this one is not next we have gingival cyst of the adult which is basically the soft tissue counterpart of the lateral periodontal cyst so you can see that its location is in between the roots of these two teeth it looks to be in the mandibular premolar area which would be its most common location and because it's only in soft tissue there's not going to be a radial lucency because we're not in bone in this case then we also have gingival cysts of the newborn and this one has some fancy words associated with bonds nodules is when the gingival cyst occurs on the lateral palette and Epstein's pearls is when they occur on the midline palate so in this image here you can see this tiny little white pearl and it's in the midline palate so we would call it an Epstein's pearl now this one as far as our origin our point of origin is again from a developmental structure and toothed embryology and so the rests are the cell remainders of dental lamina which epithelia epithelial eyes the small lesions and treatment for these is actually no treatment and they will involute or go away as infants age next we have primordial cysts which develops where a tooth would have formed so a tooth should have been there it didn't come and now we have this radiolucent pocket as most common at the mandibular third molar region and treatment would be complete removal next we have Corrado cystic Adonijah neck tumor or the cake ha for short now this is also sometimes called and was previously referred to as the O'Casey or the odontogenic Cariah cystic or Corrado cysts so it's kind of gone back and forth between being called a tumor and assists but now we're going to talk about it sort of as a mix of both so this one is aggressive and recurrent so it's definitely more aggressive than the other ones that we've talked about so far it's most common in the posterior ascending ramus of the mandible it involves this thin corrugated para keratinized epithelium if we're thinking about it histologically so now we have it's been awhile but we have another syndrome this time it's göran syndrome and this one involves multiple Kate Cox multiple basal cell carcinomas which we talked about when we talked about our cup carcinomas for mucosa it involves this calcified fall cerebri which is associated with the brain and it is actually fatal and also called avoid basal cell carcinoma so has its link this name has its link to the fact that has multiple basal cell carcinomas and so that is a very important syndrome and I feel like it's pretty frequently tested so I would remember all those little factoids associated with it treatment for this one is aggressive and nucleation so it's not enough just to go in and excise a lesion but you actually have to be very aggressive in removing that and some surrounding bone next we have calcifying odontogenic cyst and it's also called AG oral insist I say confusingly because well we just talked about the Courtland syndrome with Kate cots and now we have Gorrell insists which has nothing to do with Kate cots so that's something that's a little bit confusing and certainly doesn't help us when we're trying to remember this kind of stuff so the calcifying odontogenic cyst is rare and unpredictable and it involves most importantly these things called go cells which are empty spaces weren't the nucleus was and keratin fills it so it's a cell it's missing a nucleus you have keratin in its place and they can undergo calcification which causes these little radio densities or these tiny little radiopaque flecks and you can detect that radiographically so that's how we can determine that it's a calcifying odontogenic cyst rather than say a k cot that we just talked about alright guys and that's it for this video I hope you found it helpful if you did please leave a like and subscribe to my channel if you haven't already for more on oral pathology and other things dentistry thanks for watching guys and I'll see you all in the next video [Music]